The Lennox Herald has already told of fears the service, which gives the community access to a GP when the doctor’s surgery is shut, would be the next to face the axe at the Alexandria hospital.

It has come under intense scrutiny recently due to health chiefs being forced to shut the vital service on four separate occasions after NHS Greater Glasgow and Clyde couldn’t find enough doctors to staff it leaving sick residents having to travel to Paisley or to Gartnavel Hospital in Glasgow to be checked over.

And now, the report, which went to a HSCP meeting last week, reveals a preferred option to shut the out-of-hours service midweek due to mounting staff and funding pressures.

The plans have been on the table for at least the last couple of months — as the report is dated January 24. But the health board has repeatedly evaded our questions asking whether there were plans to scale back the service for the past two months.

Furious Scottish Labour and SNP politicians have united to condemn the latest revelation.

Dumbarton MSP Jackie Baillie fumed yesterday (Tuesday): “This is clear proof that the health board has been considering proposals to reduce the GP out-of-hours service and force local patients to travel to Paisley during the week.

“This paper was written months ago yet the health board have tried to deny that any such proposals exist and dismissed local concerns. Local patients deserve an apology as they have been lied to.”

The health board is currently undertaking a NHSGGC-wide review of the out-of-hours service to explore how it might be made more sustainable on the back of mounting cost pressures and GPs not covering shifts.

The report contained an update on the review and also revealed that other health boards in the west of Scotland pay GPs higher rates than NHSGGC — leading to high levels of unfilled shifts.

Jackie said it was baffling that the Vale hospital has been singled out despite figures in the report confirming residents from Dumbarton, the Vale and Balloch use the service more than those in Paisley.

She added: “When the official figures show that residents in Alexandria, Balloch and Dumbarton are more likely to use out-of-hours services than patients in Paisley, it makes no sense to reduce or withdraw services from the Vale.

“These proposals are clearly driven by the health board’s agenda to centralise services south of the river rather than the needs of patients in our area.”

Speaking at the HSCP meeting, SNP councillor Jonathan McColl said he was outraged by the wording of the report and tabled a motion calling for the concerns over the reduction to the service to be taken into consideration during the review.

It was unanimously backed by members of the West Dunbartonshire Integration Joint Board (IJB), comprising councillors and community health workers.

Speaking after the meeting, Councillor McColl added: “A decision appears to have been made but they have not even reached the stage of putting it out to consultation, which is hugely concerning.

“It’s worded in such a way that they want to cut the service midweek at the Vale of Leven Hospital, meaning my constituents will have to travel to the Royal Alexandra Hospital. For a long time, the agenda has been to chip away at services at the Vale and this seems to me to be another example of this.”

Soumen Sengupta, head of strategy, planning and health improvement with the HSCP, told members at the meeting that he had also understood the report to mean that the service was to be cut. He added: “The options are a work in progress.”

The Lennox Herald asked NHSGGC for a comment on the proposal to scale back the service but a spokeswoman refused to explain passed us back to the HSCP.

This is despite the health board being responsible for ensuring all patients can access out-of-hours care, as part of the General Medical Services (GMS) contract.

She said: “This paper was not developed by the HSCP. It was developed by the team responsible for delivering the current out-of-hours service as background for the review, which will be led by West Dunbartonshire HSCP alongside the other five HSCPs in the Greater Glasgow area.”

She added: “GP out-of-hours services are commissioned by the local HSCPs and it is their decision what provision they want to provide locally.

“However, a full range of options are being considered in a full review of the service by the six HSCP chief officers covering our area, including West Dunbartonshire, to explore how the service might be made more sustainable.”